Intra-Operative Twisted Gastric Sleeve: What Now?

Authors

  • André S. Valente General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal https://orcid.org/0000-0002-0629-624X
  • Alexandra Ferreira General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal https://orcid.org/0000-0003-3886-0316
  • Ana André General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal
  • Carlos Trindade General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal
  • Luís Cortez General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal https://orcid.org/0000-0002-6400-0427
  • M. Rosário Eusébio General Surgery Department, Unidade Local de Saúde da Arrábida, Setúbal, Portugal

DOI:

https://doi.org/10.34635/rpc.1156

Keywords:

Gastrectomy/adverse effects, Gastric Bypass/adverse effects, Methylene Blue, Obesity/surgery, Postoperative Complications

Abstract

Laparoscopic sleeve gastrectomy (SG) is the most common bariatric surgery performed worldwide, valued for its effectiveness in weight loss and in comorbidity resolution. However, complications such as gastric twist (also known as gastric torsion or volvulus) may require conversion procedures, like the Roux-en-Y gastric bypass (RYGB).
We aimed to examine SG indications, the causes and risks of gastric twisting, and evidence supporting RYGB as a corrective strategy, supplemented by a surgical video.
The video demonstrates the intraoperative detection of a twist during leak testing and the subsequent conversion to RYGB.
Careful assessment during the methylene blue test may reveal functional obstruction, potentially preventing delayed complications.

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References

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Published

2026-03-06

Issue

Ahead of Print

Section

Videos

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